PhDs & mental health: It’s time to talk

It is common knowledge that there is a mental health crisis
in graduate education – and within academia as a whole [1]. Statistically, one
in two PhD students will experience a mental health problem at some point
during their studies. The percentage of PhD students at risk of having or
developing a mental health problem during their studies (i.e., approximately
3-4 years) almost equals the lifetime prevalence of mental health problems in
the general population [2].

What is the extent of the problem?

The 2013 survey which examined the mental health of PhD
students in Flanders, Belgium [2], found that 51% of PhD students experienced psychological
distress. Approximately 30% experienced so many symptoms that they were at an
extremely high risk for having or developing a mental health problem. The most
commonly reported symptoms of poor mental health were: feeling under constant
strain, being unhappy and depressed, losing sleep because of worry, and not
being able to overcome difficulties or enjoy day-to-day activities. This risk for
PhD students is significantly greater than it is for the highly educated
general population, highly educated employees and higher education students [2].

In a similar study of US PhD students, approximately 40% met
the criteria for anxiety and 40% for depression – this is six times higher than
the US general population. Yet, the levels of help-seeking within this
high-risk population are low, with the Nature Graduate Survey identifying that,
of the researchers and PhD students who reported feeling concerned about their
mental health, only 12% sought professional help [3].

Factors associated with mental health

Mental distress is complex and no single factor can be held
accountable. However, several factors have been found to be associated with the
increased risk of suffering from a mental health problem.

One of the most important factors is a poor work-life
balance. A recent PhDnet survey [4] found that PhD students worked an average
of 47 hours per week, with 81% working more than their contractually obligated
hours. Worryingly, 75% worked at least one weekend per month and 20% felt that
they were not able to take their contractually granted holidays due to their
high workload. Finding a good work-life balance is particularly important as
long working hours are highly correlated with burnout [5].

The PhDnet survey showed that student-supervisor
relationships are also linked to student mental health. Supervision
satisfaction is highly correlated with general satisfaction, suggesting that
the quality of supervision is related to the overall experience of a PhD
student [4]. Fortunately, the survey showed that 72% of PhD students reported
being either “very satisfied” or “satisfied” with their supervision.
Furthermore, one study showed that having an inspirational supervisor partially
offsets the risk of having a mental health problem [2].

Several other factors are thought to be associated with the
high prevalence of mental distress in PhD students, however, research is
extremely limited. For example, the change from feeling successful throughout
your undergraduate degree, to suddenly receiving more critical feedback, can be
damaging to your self-esteem. This leads to Imposter Syndrome, which is defined
as the persistent inability to believe that one’s success is deserved or has
been legitimately achieved [6]. In addition, it is thought that many PhD
students would be described as having a Type A personality. Type A individuals
are hypothesised to be “high-achieving workaholics”, and are also thought to
experience more job-related stress and less job satisfaction [7]. This
combination may also increase the risk of having poor mental health.

Financial problems are an additional cause of stress for PhD
students, on top of the existing stress from job demands and workload – PhDs
are not well paid. If you are fortunate enough to get external funding, this is
approximately £14,000 a year, in the UK (slightly more in London). Considering
the average hours worked, this works out as below the minimum wage. Part-time
jobs can help with financial worries, but this puts you at a much higher risk
of burnout. Moreover, PhDs normally take approximately 3-4 years, yet funding
often stops after 3 years, meaning the remaining months are unpaid.

How to look after your mental health during a PhD

These statistics can be very daunting when beginning a PhD.
But there are several things you can do on an individual level to look after
your mental health.

Take the time to look after your physical health – eat
well-balanced meals, exercise frequently, even if it is just walking. Get out
of the office and go outside for a quick break.

It may help to join a club outside of the University. Meeting
other people who are not doing a PhD can be refreshing and a useful way of
taking your mind off work. Or get a hobby – anything which will help to create
a healthy work-life balance. It’s important to remember that your PhD is not
the be-all-and-end-all.

Talking about how you are feeling, particularly if you are
struggling, can be an effective way to relieve your distress. Talk to your
friends, your family, your peers, and if you feel comfortable, talk to your
supervisor. If your supervisor recognises that your mental health is
struggling, they can offer advice on the next steps.

If you feel that your mental health is suffering – seek help. The statistics show that PhD students are at an increased risk of having a mental health problem, so if you do feel like you need professional help, it’s quite likely that you do. Most Universities have available counselling and mental health services, or you can visit your GP. There are also several online services or mental health help lines (see the NHS website for a comprehensive list).

What needs to change in the system?

Although there are things you can do to look after your
mental health, it should not have to come to that. There needs to be widespread
changes within academia itself. If 50% of people suffered from mental distress
in any other occupation, fundamental action would be taken. So why does this
seem acceptable in academia?

PhD students should be offered more financial support. The
length of studies should increase to reduce pressure from the workload. The
number of PhD students per supervisor should be reduced in order to prevent
supervisors being too far stretched which would allow the development of better
quality supervisor-student relationships. Relief courses should be provided by
institutes within Universities, and should be made available to all PhD
students and academic staff. There needs to be more mental health support
provided by Universities. However, this sounds great in theory, but is
difficult to implement in practice without government support and widespread
changes to the expected workload which is so ingrained within academia.

It’s not all doom and gloom, it seems as though institutions
are making some changes to improve the mental health crisis. A couple of weeks
ago saw the opening of the first international meeting on postgraduate mental
health in Brighton. The two-day meeting aimed to address the fact that many PhD
students and postdoctoral researchers are overworked and overstressed, leading
to this mental health crisis. The Higher Education Funding Council for England
and the UK Research Innovation have given £1.5 million to fund a series of 17
projects, which began in March 2018, aiming to better understand the causes of
mental health problems in early-career researchers and what kinds of support
their Universities can provide.

However, international data is lacking, most studies have
incomplete data or often only apply to an individual University or region.
Nature Research suggests that more wide-scale research is needed to understand
the extent of the post-graduate mental health crisis and the predictors. It is
important that we continue talking about the mental health crisis in academia
until fundamental changes are made.

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